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北京今年招募千名文保志愿者 长城是巡视重点

2019-08-24 13:50 来源:中国贸易新闻

  北京今年招募千名文保志愿者 长城是巡视重点

  TheUnionofEuropeanFootballAssociations(UEFA)ChampionsLeaguetrophyisdisplayedonstageasatrailerfortheFIFA19soccervideogameisshownduringanElectronicArtsInc.(EA)PlayeventaheadoftheE3ElectronicEntertainmentExpoinLosAngeles,California,US,onJune9,2018.[Photo/VCG]AspiritofadventuresweptthroughthisseasonsChampionsLeague,servingupartgetourhopesup."Nationalteamsoftenlagbehindtheclubs,anditsunderstandablewhy,"saidJonathanWilson,authorofInvertingthePyramid:TheHistoryofFootballTactics."Theresatendencytokeepthingsprettysimpleattheinternationallevel,"saidWilson."Ithinktherewil"Thisviewpointstemsfromthesimplenotionthatinternationalcoachesdontgetasmuchtimewiththeirplayersastheirclubcounterparts,andthatitseasierfo,,BrazilsWorldCup-winningcoachfrom1994,isnowamemberofFIFAstechnicalstudygroup,andhepredictedanapproachthatwillseeteams"defendwithasmanyplayersaspossible"andplayonthecounterattack."Verycompactteams,withlotsofplayersbehindtheball,closingdownspaceandplayingatpaceontheattack,",ofcourse,ishopingforfree-flowingsoccerandplentyofgoalsinRussia,followingonfromaWorldCupinBrazilin2014thatthegoverningbodyspanelofcoachingexpertssaidsawteams"playpositivelyanddoeverythingtowinagameratherthanmerelynotlose".,,06and10,srebrandin1992,,FIFAschieftechnicaldevelopmentofficer,thinkssoccerhasbeenplayedmorepositivelysinceBarcelonasrecentsuccessusingtheapproachfirstimplementedattheclubbyJohanCruyffinthe1990sandpreviouslybyCruyffsDutchcoachRinusMichelswithhis"TotalFootball"philosophyinthemid-1970s."AsaconsequenceofthesportingsuccessesBarcelonagainedwiththatplayingstyle,manycoachesliketheirteamstoplayattackingfootball,"VanBastensaid."eofplay,butintheendresultscountaswell."Themostcommonformationsthissummerwillbe4-2-3-1andthe4-3-3u,thethree-mandefensehasmadeacomebackofsortsthisyear,withEngland,,withSpain,GermanyandEnglandexpectedtofollowsuit."NoteamwillwintheWorldCupwithoutpressing,"Wilsonsaid."ButIthinktherewillbeafargreatertendencytositdeepandtrytoabsorbpressure."AssociatedPressKulangsu,asmallislandofftheshoreofXiameninFujianprovince,andHohXil,anaturereserveinQinghaiprovince,wereaddedtothkow,,calledKulangsuinthelocaldialectandknownforitswell-preservedhistoricalbuildings,andHolXil,aplateaufamousforitsnaturalbeautyandbiodiversity,Chinanowhas52sitesinscribedontheUNESCOWorldHeritagelist,whichwasestablishedtosafegsrecaponthe52heritagesitesinChina,whichmaygiveyousomecluesonyournexttravelplan.

TocelebrateandhighlightChinasoutstanding,innovativeanddedicatednon-nativeteachersofEnglish,theBritishCouncilannouncedthefirstwinneroftheEnglishisGREATteacherAwardsroomactivities,thejudgingpanel,comprisedofexpertsfromBritishCouncilsEnglishinEducationSystems(EES)team,selectedHuConghuifromSouthChinasGuangdongprovinceasthewinnerofthe1stEnglishisGREATTeacherAward."HudidthywinnerofMaysEnglishisGREATTeacherAward,"saidtheexperts."TeachingEnglishasanon-nativespeakerisaninvaluableskillandonewhichrequirestruededicationandgenuineenthusiasmforteachingaswellasadeepunderstandingoftheEnglishLanguage,"KiranPatel,directorofStrategicCommunicationsandCorporateRelationsoftheBritishCouncilChina,said."spassionforteachingshonebrightlythroughouthersubmissionandinahighlycompetitivefieldofoutstandingteachers,thisstoodheroutasaveryworthyandinspiringwinner."Asthefirstmonthlywinner,HuwilljointhegrandfinaleinDecemberalongwithotherwinnersalongtheyearforthefinalprize–EnglishisGREATcampaign,aimedatempoweringChinesepeoplewiththeconfidenceandabilitytomasterEnglishcommunicationskills,waslaunchedduringtheUKPrimeMinisterTheresaMaysvisittoChinaonJanuary31,nambassadors–-,click.,Minnesota,US,June12,2018,inthisimageobtainedfromsocialmedia.[Photo/Agencies]MINNEAPOLIS—Araccoonthatbec,Minneapolis,US,,accordingtoWildlifeManagementServices,"Itseatingnormally,"saidChristinaValdivia,thecompanysgeneralmanager,sadventurescausedastironsocialmediaasitscaledthetowerTuesday,withmanyTwitterusersvoicingconcernforitssafetyorjokingaboutthedramaasits,,afemale,wasreleasedlaterinthedayandscamperedin,whichbrokethestoryandcloselyfollowedtheraccoonsclimbfromitsheadquarterslessthanablockaway,brandedtheanimal#mprraccoon.

  TocelebrateandhighlightChinasoutstanding,innovativeanddedicatednon-nativeteachersofEnglish,theBritishCouncilannouncedthefirstwinneroftheEnglishisGREATteacherAwardsroomactivities,thejudgingpanel,comprisedofexpertsfromBritishCouncilsEnglishinEducationSystems(EES)team,selectedHuConghuifromSouthChinasGuangdongprovinceasthewinnerofthe1stEnglishisGREATTeacherAward."HudidthywinnerofMaysEnglishisGREATTeacherAward,"saidtheexperts."TeachingEnglishasanon-nativespeakerisaninvaluableskillandonewhichrequirestruededicationandgenuineenthusiasmforteachingaswellasadeepunderstandingoftheEnglishLanguage,"KiranPatel,directorofStrategicCommunicationsandCorporateRelationsoftheBritishCouncilChina,said."spassionforteachingshonebrightlythroughouthersubmissionandinahighlycompetitivefieldofoutstandingteachers,thisstoodheroutasaveryworthyandinspiringwinner."Asthefirstmonthlywinner,HuwilljointhegrandfinaleinDecemberalongwithotherwinnersalongtheyearforthefinalprize–EnglishisGREATcampaign,aimedatempoweringChinesepeoplewiththeconfidenceandabilitytomasterEnglishcommunicationskills,waslaunchedduringtheUKPrimeMinisterTheresaMaysvisittoChinaonJanuary31,nambassadors–-,click.USPresidentDonaldTrumpwalkswiththeDPRKstopleaderKimJong-unattheCapellahotelonSentosaislandinSingaporeonTuesday.[Photo/Agencies]Themorningafter,,2018historicsummitbetweenUSPresidentDonaldTrumpandDPRKChairmanKimJong-un,,theDPRKonceapariahhermitstateiscomingoutstoliftthesanctionsMoreover,atwhatprice,andhowmuchaidwillAmericaneedtoprovidetheDPRKforthisimpoverishednationtoge‘nothing,’inglaborcostsofChina’,,RudiSirrbelievesthatthechallengewillnotbeinluringforeigninvestment.“ndustriesthatneedtogrowwithoutcreatingeitherunnecessarydebtorinflation,”tment,butconcernedthattheinvestmentswillcomeininanirrational’sintentionistocreateasystematicandcontrolledmeansofopeningtheeconomygradually,,“NorthKoreahaslearnedtolive,itmayactuallyproveabenefitastheysequencetheopeningon,unnecessarilyredundantinvestmentsandexternaldebtallofwhichcanbedestabilizingforthecountrysociallyeconomicallyandpolitically.”China’sBeltandRoadInitiativecanofferpracticalsolutionsfortheDPRK’“Chinasolution,”thefirstpriorityfortheDPRKshouldbetogettheinfrastructureinplaceforrai,transshipmentofRussiancoalfromSiberatoPuson’,,theDPRKhasamoreambitiousvisiontoextendthisraillinkallthewaytoSouthKoreathereby,theDPRKenvisionsthatthroughRajin,andtheoverlandrailnetworkextendingacrossSiberia,withaBRIupgrade,,,inancienttimes,’,everyoneinEastAsiahasaneconomicinterestinseeingsanctionsliftedagainsttheDPRKsotheycangetonanddobusiness.“Collectivelythisaffects600millionpeo,ifmanagedproperly,willsolvealotoftheDPRK’sproblems,”,therealquestioniswillWashingtonofferaclearandreasonableblueprinttoliftsanctionsThisiswhattheinvestmentbankersarewaitingfor,ternationalFellowattheCenterforChinaandGlobalization.

  TouristsvisitagardeninSuzhou,es.[PhotoprovidedtoChinaDaily]Chinasbiggestonlinetravelagency,Ctrip,launchswebsiteorapp,suchaspackageticketsthatcoverdestinationsclassicattractions,public-transportationcards,exhibitions,rockclimbing,bungeejumping,needs,Ctripinesetravelersabroad,supplychannelstogivetravelerstheflexibilitytomakeimpromptudecisions,sself-serviceplatformoffers35,000productsinover100countries,includingJapan,SouthKorea,rgingdestinationstoputtheirproductsontheplatform,suchastrainridesinArgentinasUshuaia."Wefoundyoungpeopleareincreasinglyspontaneousinmakingtravelplans,"Yusays."Someevenmakedecisionsafterarrival."Over5milliontravelersusedCtripforoverseastravelinthefirstthreemonthsoftheyear,a150percentincreaseoverthesameperiodlastyear,90saccountfornearlythree-quartersoftheself-serviceplatform,daytours,WiFi,tour-guidebookingandpackagetickets,Ctripreports."Theplatformopensupahugespacetoservetourisminnovation,",NewYork,Shanghai,FujianprovincesXiamenandJiangsuprovince,suchasKoreanandJapanese,Yusays.JapanesePrimeMinisterShinzoAbe(left)attendsanewsconferencewithUSPresidentDonaldTrumponWednesdayinPalmBeach,Florida,US.[Photo/Agencies]AttheirmeetinginMar-a-Lago,Florida,onApril18,USPresidentDonaldTrumprebuffedJapanesePrimeMinisterShinzoAbe,TrumpannouncedthattheUSwonewtariffs,whichwillamounttoabout50billionyen($450million)ayearforJapandespiteAbeworkinghardtocultivateacloserelationshipwithTrump-ountermeasuresagainstUStariffs,sprotectionistpolicies,Japanhassignedorisnegotiatingmultilateraltradeagreements,which,itbelieves,,theJapaneseparliamentisworkingtowardratifyingtheComprehensiveandProgressiveAgreementforTrans-PacificPartnership,,JapanseestheTPP-11asacornerstoneonwhichitcn,too,inDecember,andthetwosidesaremaki,t,16countriesreachedaconsensustocompleteabasicframe,itwillproducethemostpopulous,diverseandenergeticfreetradeareaintheworld,,theleadersofChina,JapanandtheROKadvocatedeconomicglobalizationandfreetrade,andagr,,duringPremierLiKeqiangsvisittoJapan,BeijingandTokyoagreedtoestablishapublic-privatecounciltodiscussjoi,Japandoesnotwanttonegotiateatwo-waytrexploringcouldbackfireworldwide,sprotectionistpolicieswil,theUShasaskedJapan,aswellasitsotherallies,sdefensebudgethasalreadybeenrisingeveryyearundertheAbeadministrationendingadecadeofmilitarybudgetcuts,

ZhangXinyanofChina(frontcenter)competesintheWomens3000msteeplechaseround1onday8oftheRio2016OlympicGamesattheOlympicStadiumonAug13,2016,RiodeJaneiro,Brazil.[Photo/VCG]ChineseathletestraveltoEastAfricaforjointtrainingcampZhangXinyanhadsoundknowledgeofKenyasprowessinglobalathleticsbeforeshevisitedtheEastAfricannationinlateApriltoparticipateinamonth-longtrainingcampontheoutskirtsofEldoret,atownknowntoKenyansasthe"HomeofChampions".The24-year-oldmiddle-distancerunnerfromGansuprovincylandedinKenyaatthepeakofrainyseasoninApriltomeetthecountrysbignamesinmiddle-andemselvestothehumidweatherandruggedterrsofEldoret,ZhangreunitedwithHyvinKiyengJepkemoi,Kenyas26-year-oldsteeplechaseiconwhobaggedagoldmedalatthe20,theduohadinstantchemistryastheysharedfondmem,wheretheChineseandKenyantrackteamswereconspicuous."IcouldnotfathomareunionwithsomebodyIconsideraheroineinthe3000msteeplechase,andourtraininghereintheHomeofChampionswilldefinitelybeagame-changerinourcareers,"ghesteem,andtrainingwiththemwouldbeaboontohercareer."ItfeelsgreattominglewithperthatIamslatedtoparticipatein,",describingitasa"joyousoccasion"sinceitmesandnghai,whereshewasstruckbythenationshigh-altitudelandscapesofferanidealtraininggroundforathletesaimingtomaintaintheiredge,andZhangandhercolleagueswerebeamingwithconfidenceastheypreparedforthefinalstageoftheirtrainingattheEldoretcamp,whichisabout2,,acoachoftheYunnantrack-and-fieldteam,saidthegruelingtrainingboostedtheenduranceofChineseathletesastheyprepareforupcomingraces,includingthenationalathleticschampionshipsinGuiyangCity,capitalofsouthwesternChinasGuizhouprovince,laterthismonth."Trainingatanelevatedaltitudethatisenergy-sappingwillhelpourathleteshandlegruelingracesathomeandinforeigncountrieswithease,"ncerunnerZhangDeshun,,whichishometosomanyworld-classathletes."Theatmosphereofjustfocusingonrunningfasthelpsmealot,"hesaid.

  ThehistoricwineryDomainedeRombeauinFranceiseyeingalargershareintheglobalmarket,especiallyinChina.[PhotoprovidedtoChinaDaily]Youngconsumersdriveg,oneofthelargestexhibitionsforwineandspiritsintheworld,andUK-basedInternationalWineandSpiritResearch,thegrowthrateoftheChinesewinem,Chinawouldbecomethesecondlargestwinemarketintheworldwithavalueof$23billion,esecentralgovernmentrolledoutasweepinganti-corruptioncampaignin2013,thisincidenthadatthesametimeresultedinaboominthemasssegmentasmoreimportersanddealersfloodedthemarketwithbottlesthatcostbelow$,,CEOofVinexpo,saidthattheseconsumershavebecomeoneofthekeygrowthenginesfortheChinesewinemarket."ThereusedtobeaweirdphenomenoninChinaswinecirclewherepeoplewhobuydontdrink,andthosewhodrinkdonrealdrinkers,"soriginisthemostdecisivefactorforChineseconsumerswhenpickingabottle,andFrance,whichisthelargestwineexportertoChina,,whichpolledabout2,500youngwinebuyers,alsofoundthatwinestandardsorpreferenceshavenotemergedonanationalbasis,likeRaspaud."IamtoldthatChineseconsumerswanttobedifferentandindividualistic,beitintheirchoiceofwineorfashion,"saidRaspaud,,theFrenchmansaidthathiswinerywouldbetheequivalentofanindependeein,hehasunder,DomainedeRombeauexported60,

  TheartexhibitionSanctuaryisunderwayatLangYuanVintageinBeijinguntilJune19.[]myplace."Itislikereopeningaworldforgottenbyhumanbeings,"Jean-CharlesPenot,artistoftheshow,saidtoChinaDailywebsite."Alongtimeago,epowerofwaterandhowwaterbringslifeandhopetopeople."GrowingupinacoastaltownnearBordeauxofFrance,Penotwasdeeplyinfluencedbyhisgrandfatherandbecameanatureloverhimself."Hetaughtmetogrowvegetables,showedmethebeautyoftheforest,namesofeverysingleplant,"Penotsaid."Mygrandpataughtmehowtorespectnatureandhownaturewillalwaysgiveyouback."Beyondsformerbassist,WongKakeung(left)withhisbrotherWongKakuiswaxreplicainMadameTussaudsBeijing.[PhotoprovidedtoChinaDaily]WongKa-kuisclassicythmguitaristofthelegendaryHongKongrockband,Beyond,soitisonlyfittingtha,andthe25thanniversaryofhisaccidentaldeath,theworld-famousattractionrecentlyunveiledawaxfigurefeaturingthestarwithhisiconiclook."Itreappearonstage,"saysthelate-singersyoungerbrotherandBeyondsformerbassist,WongKa-keung,whoattendedtheunveilingceremonyatthewaxmuseum."ThewaxreplicaissorealthatmyfamilyandIweremovedbeyondwordswhenwefirstsawitspicture,"heexplains."Thefeatures,suchasthemouthandnose,"

  ,Minnesota,US,June12,2018,inthisimageobtainedfromsocialmedia.[Photo/Agencies]MINNEAPOLIS—Araccoonthatbec,Minneapolis,US,,accordingtoWildlifeManagementServices,"Itseatingnormally,"saidChristinaValdivia,thecompanysgeneralmanager,sadventurescausedastironsocialmediaasitscaledthetowerTuesday,withmanyTwitterusersvoicingconcernforitssafetyorjokingaboutthedramaasits,,afemale,wasreleasedlaterinthedayandscamperedin,whichbrokethestoryandcloselyfollowedtheraccoonsclimbfromitsheadquarterslessthanablockaway,brandedtheanimal#mprraccoon.

  LiuQiangdong,,addressestheInternet-drivenPoverty-alleviationForumatthe4thWorldInternetConferenceunderwayinWuzhen,ZhejiangprovinceonDec3.[PhotobyXiangWenjian/]Afteraperiodofworld-historicpovertyreduction,Chinafacesadifficult"lastmile",governments,socialorganizationsandenterprisesmustmakeuseoftheinternettoliftthelastcohortofimpoverishedpeopleintoabetterlife—andatthe“SharingofDividends”forum,partofthe4thWorldInternetConferenceinWuzhen,alleviationsolutionstheydfoundthroughtheirexperiences,,speakeverishedcitizenstojointhe,,discussedboththebuildingoflogisticsinfrastructuretomakee-commerceshippingeasierandthedevelopmentofmarketsforpremium,,arecipientofChina’snationalpovertyalleviationaward,ofagriculturewhileconnectingfarmerstocustomersthrough“povertyalleviationstores”,where,urbanpopulationshungryforhigher-qualityproduceandmeatwillbehappytopayahigherprice—andbecausepurchaseshappeninbulkoversetperiodsoftime,farmerswillnoe,,essentialservicescanalsoreachremoteregionsofthecountry,,healthcareandeducationcanbedigitized,allowingtrainedmedi,streamedlive,helptraintheyoungergenerationsandappslikeWeD,thi’an,executivevicepresidentoftheAgriculturalDevelopmentBankofChina,said,theclosertoinformation,themarketandeducationapersonis,,ChinaandtheworldhaveauniqueoppoviewsofChinaDailyandChinaDailywebsite.Explosionslituptheskieswithanti-aircraftfire,overDamascus,theSyriancapital,astheUSlaunchesanattackonSyriatargetingdifferentpartsoftheSyriancapitalDamascus,Syria,April14,2018.[Photo/VCG]TheUnitedStatesanditsallieswagedmorethan100strikesonSyriaonFridayina"onetimeshot"eemainchemicalweaponsfacilitiesweretargetedbybothmissilesfromtheseaandfiredfromaircraft,schemicalweaponscapabilitywithoutkillingciviliansorthemanyforeignfightersinSyriasmulti-sidedcivilwar,particularlythosefromRussia."WespecificallyidentifiedthesetargetstomitigatetheriskofRussianforcesbeinginvolved,"Dunfordtoldreporters,addingtheUSmilitaryadvisedRussiaofairspacethatwouldbeusedinthestrikebutdidnot"pre-notifythem."MattisacknowledgedthattheUSwagedtheattacksonlywithconclusiveevidencethatchlorinegaswasusedintheApril7attackinSyria.

  TheUnionofEuropeanFootballAssociations(UEFA)ChampionsLeaguetrophyisdisplayedonstageasatrailerfortheFIFA19soccervideogameisshownduringanElectronicArtsInc.(EA)PlayeventaheadoftheE3ElectronicEntertainmentExpoinLosAngeles,California,US,onJune9,2018.[Photo/VCG]AspiritofadventuresweptthroughthisseasonsChampionsLeague,servingupartgetourhopesup."Nationalteamsoftenlagbehindtheclubs,anditsunderstandablewhy,"saidJonathanWilson,authorofInvertingthePyramid:TheHistoryofFootballTactics."Theresatendencytokeepthingsprettysimpleattheinternationallevel,"saidWilson."Ithinktherewil"Thisviewpointstemsfromthesimplenotionthatinternationalcoachesdontgetasmuchtimewiththeirplayersastheirclubcounterparts,andthatitseasierfo,,BrazilsWorldCup-winningcoachfrom1994,isnowamemberofFIFAstechnicalstudygroup,andhepredictedanapproachthatwillseeteams"defendwithasmanyplayersaspossible"andplayonthecounterattack."Verycompactteams,withlotsofplayersbehindtheball,closingdownspaceandplayingatpaceontheattack,",ofcourse,ishopingforfree-flowingsoccerandplentyofgoalsinRussia,followingonfromaWorldCupinBrazilin2014thatthegoverningbodyspanelofcoachingexpertssaidsawteams"playpositivelyanddoeverythingtowinagameratherthanmerelynotlose".,,06and10,srebrandin1992,,FIFAschieftechnicaldevelopmentofficer,thinkssoccerhasbeenplayedmorepositivelysinceBarcelonasrecentsuccessusingtheapproachfirstimplementedattheclubbyJohanCruyffinthe1990sandpreviouslybyCruyffsDutchcoachRinusMichelswithhis"TotalFootball"philosophyinthemid-1970s."AsaconsequenceofthesportingsuccessesBarcelonagainedwiththatplayingstyle,manycoachesliketheirteamstoplayattackingfootball,"VanBastensaid."eofplay,butintheendresultscountaswell."Themostcommonformationsthissummerwillbe4-2-3-1andthe4-3-3u,thethree-mandefensehasmadeacomebackofsortsthisyear,withEngland,,withSpain,GermanyandEnglandexpectedtofollowsuit."NoteamwillwintheWorldCupwithoutpressing,"Wilsonsaid."ButIthinktherewillbeafargreatertendencytositdeepandtrytoabsorbpressure."AssociatedPress

  TheartexhibitionSanctuaryisunderwayatLangYuanVintageinBeijinguntilJune19.[]myplace."Itislikereopeningaworldforgottenbyhumanbeings,"Jean-CharlesPenot,artistoftheshow,saidtoChinaDailywebsite."Alongtimeago,epowerofwaterandhowwaterbringslifeandhopetopeople."GrowingupinacoastaltownnearBordeauxofFrance,Penotwasdeeplyinfluencedbyhisgrandfatherandbecameanatureloverhimself."Hetaughtmetogrowvegetables,showedmethebeautyoftheforest,namesofeverysingleplant,"Penotsaid."Mygrandpataughtmehowtorespectnatureandhownaturewillalwaysgiveyouback."

  Musicians(fromleft)ChangChenyue,MCHotdog,KrisWu,GloriaTangTszkeiandWilberPancomposethejuryfortheupcomingnewseasonofTheRapofChina.[PhotoprovidedtoChinaDaily]WhenthefirstseasonofTheRapofChina,arealityshowonhip-hop,waspremieredthroughstreamingmediaplatformiQiyilastJune,,C,asongwrittenin2015byrapperPGOne-oneofthewinnersinthefirstseasonofTheRapofChina-wascriticizedinJanuarybytheoffic,allmusicbyPGOne,whoserealnameisWangHao,inashowwouldhaveanotherseason.ChinaSouthernAirlineswillopenthecountrysfirstregulardirectflightfromHainantoEurope,lishedatrialprogramaimingtooffer,acoastalcityinVietnam,willcommenceoperationonJuly2,accordingurghAirportinamomentousdayScotland,ministerofjustice,emphasizedthenecessityoflegalsupportfortheconstructionoftheHainanpilotfreetrationatthelaunchceremonyofHainans2018EnergyCons"InvestmentandTalentAttractionNetofChina(Hainan)PilotFreeTradeZoneandFreeTradePortwithChineseCharacteristic"hasstartedtrialoperation.

  

  北京今年招募千名文保志愿者 长城是巡视重点

 
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来源: 新华社 编辑:程小欣 时间:2019-08-24 09:46:19  

  新华社上海5月4日电(仇逸、孙国根)在科技部和国家自然基金委资助下,复旦大学基础医学院高谦教授、柳清云博士等人员历经4年研究,与美国国立卫生院等合作,揭示了多药联用下病人体内结核菌的“微变化”过程,对降低结核病人耐药率和提高治愈率具有重要意义。

  耐药率的攀升是结核病防控面临的巨大挑战。为提高结核病人的治愈率,世界卫生组织建议结核病治疗方案中应至少应包括4种“有效药物”,传统的耐药检测需耗时1至2个月,临床上大部分结核病人未进行耐药检测,主要依赖经验性治疗,存在较大的盲目性。如果病人感染的是耐药菌,很容易导致治疗方案中有效药物数量小于4种;在这种情况下,病人体内结核菌的基因组会发生什么改变?是否会导致进一步的耐药性积累?这些问题一直有待明晰。

  高谦领衔的科研团队应用超深度全基因组测序技术,从52例结核病人中选取了12例具有代表性的病人,对治疗前后不同时间节点共53个样本进行深度测序,观察和检测结核菌群体中的比例较低的突变,并追踪和深入研究这些突变的动态变化。研究发现,病人体内结核菌群体中存在大量的比例较低的突变。在有效药物数量大于4种的治疗方案下,结核菌群体中的低频突变会受到强烈清除,并使结核菌群体在遗传上保持稳定,未发现耐药突变的积累。但在有效药物数量少于4种的治疗方案下,结核菌的变化则截然不同:携带耐药突变的结核菌在群体中的比例不断上升,结核菌从敏感变成耐药,并出现由低浓度耐药向高浓度耐药转变。

  研究说明,多药联用治疗方案中的有效药物数量是决定结核菌是否发生耐药性积累的关键。如果结核病人感染的是一株耐药菌株,并且已经对某些药物耐药,如果再继续使用这些药物只会进一步增加耐药性积累的风险,从而影响治疗效果。

  专家认为,临床中的经验性治疗很容易导致治疗方案中有效药物数量偏少、结核菌在治疗过程中进一步积累新的耐药突变现象,影响治愈率。及时准确地掌握耐药检测结果,对制定和调整治疗方案尤为重要。新的快速耐药诊断技术的推广应用迫在眉睫。

  结核病目前依然是全球面临的最主要传染病威胁之一。研究成果已在线发表在最新一期的国际著名生物遗传学期刊《基因组生物学上,引起学界关注。

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